Vaginal surgical apparatus

ABSTRACT

This invention relates generally to a medical device, and more specifically, to a vaginal surgical apparatus. In one embodiment, an apparatus includes, a vaginal manipulator probe that is at least partly insertable into a vagina, the vaginal manipulator probe including an end portion that includes a bullous tip and that includes a space that accommodates a cervix therewithin; and at least one prominence incorporated with the vaginal manipulator probe operable to assist with identifying one or more positions of at least one anatomical structure or orienting the vaginal manipulator probe.

PRIORITY CLAIM

This application is a continuation-in-part of U.S. non-provisionalpatent application Ser. No. 16/030,701 filed on Jul. 9, 2018, which is acontinuation of International Application PCT/US16/37014 filed on Jun.10, 2016, and U.S. non-provisional patent application Ser. No.15/691,194 filed Aug. 30, 2017, which is a continuation of U.S.non-provisional patent application Ser. No. 15/480,227 filed on Apr. 5,2017, which is a continuation of Ser. No. 15/208,867 filed Jul. 13,2016, which is a continuation of Ser. No. 15/179,215 filed Jun. 10,2016, which application is (a) a non-provisional patent application ofU.S. provisional patent application 62/174,127 filed Jun. 11, 2015; U.S.provisional patent application 62/193,721 filed Jul. 17, 2015; U.S.provisional patent application 62/252,810 filed Nov. 9, 2015; U.S.provisional patent application 62/257,090 filed Nov. 18, 2015; U.S.provisional patent application 62/265,038 filed Dec. 9, 2015; and U.S.provisional patent application 62/312,069 filed Mar. 23, 2016; (b) acontinuation-in-part of U.S. non-provisional patent application Ser. No.13/852,784 filed May 31, 2013; and (c) a continuation-in-part of U.S.nonprovisional patent application Ser. No. 14/971,512 filed Dec. 16,2015.

This application claims the benefit of and/or priority to each of theforegoing patent applications and any and all parent, grandparent, andgreat-grandparent applications thereof. The foregoing patentapplications are incorporated by reference in their entirety as if fullyset forth herein.

FIELD OF THE INVENTION

This invention relates generally to a medical device, and morespecifically, to a vaginal surgical apparatus.

SUMMARY

This invention relates generally to a medical device, and morespecifically, to a vaginal surgical apparatus. In one embodiment, anapparatus includes, but is not limited to, an elongated handle portion;a vaginal manipulator probe that is at least partly insertable into avagina, the vaginal manipulator probe extending from the elongatedhandle portion and including an arcuate end portion, the arcuate endportion including an aperture for accommodating a cervix; and a diskthat is movable along at least a portion of a length of the vaginalmanipulator probe, the disk including a locking mechanism to releasablysecure the disk in position to limit vaginal insertion depth of thevaginal manipulator probe. In another embodiment, an apparatus includes,but is not limited to, an elongated handle portion that includes a firstbollard tab and a second bollard tab for releasably securing a suture; avaginal manipulator probe extending from the elongated handle portionand including an arcuate end portion having an oval-cross sectionalshape and having an aperture channel for accommodating a cervix; and adisk that is movable along at least a portion of a length of the vaginalmanipulator probe, the disk including a locking mechanism to releasablysecure the disk in position to limit vaginal insertion depth of thevaginal manipulator probe. In a further embodiment, an apparatusincludes, but is not limited to, an elongated handle portion thatincludes a first bollard tab and a second bollard tab for releasablysecuring a suture; a vaginal manipulator probe extending from theelongated handle portion and including an arcuate end portion having anoval-cross sectional shape and having an aperture channel foraccommodating a cervix, the arcuate end portion terminating to a bulloustip; a disk including a sleeve and shoulder, the disk being movablealong at least a portion of a length of the vaginal manipulator probe;and a spring loaded latch associated with the disk to releasably securethe disk in position along a length of the vaginal manipulator probe tolimit vaginal insertion depth. In yet an additional embodiment, anapparatus includes, but is not limited to, a handle portion; a vaginalmanipulator probe that is at least partly insertable into a vagina, thevaginal manipulator probe extending from the handle portion andincluding an arcuate end portion, the arcuate end portion including anchannel for accommodating a cervix; one or more LED lights disposed onthe vaginal manipulator probe for illuminating vaginal tissue; at leastone camera positioned with a field of view of the channel to permitvisualization of a cervix relative to the channel; at least one batteryreceptacle within the handle portion; at least one button or switchoperable to control operation of the one or more LED lights; at leastone communication link for transferring image data to at least onedisplay unit, the at least one communication link being either a wiredcommunication link or a wireless communication link; and a disk that ismovable along at least a portion of a length of the vaginal manipulatorprobe, the disk including a locking mechanism to releasably secure thedisk in position along the portion of the length of the vaginalmanipulator probe to limit vaginal insertion depth of the vaginalmanipulator probe.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present invention are described in detail below withreference to the following drawings.

FIG. 1 is a top perspective view of a vaginal surgical apparatus, inaccordance with an embodiment of the invention;

FIG. 2 is a bottom perspective view of a vaginal surgical apparatus, inaccordance with an embodiment of the invention;

FIG. 3 is a perspective view of a handle portion of a vaginal surgicalapparatus, in accordance with an embodiment of the invention;

FIG. 4 is a perspective view of a vaginal manipulator probe of a vaginalsurgical apparatus, in accordance with an embodiment of the invention;

FIG. 5 is a perspective view of a vaginal manipulator probe of a vaginalsurgical apparatus inserted into a vaginal space, in accordance with anembodiment of the invention;

FIG. 6 is a perspective view of a movable handle of a vaginal surgicalapparatus, in accordance with an embodiment of the invention;

FIG. 7 is a perspective view of a vaginal surgical apparatus with one ormore prominence features, in accordance with an embodiment of theinvention;

FIG. 8 is a perspective view of a vaginal surgical apparatus with one ormore prominence features, in accordance with an embodiment of theinvention;

FIG. 9 is a perspective view of a vaginal surgical apparatus with one ormore suction ports, in accordance with an embodiment of the invention;

FIG. 10 is a perspective view of a vaginal surgical apparatus with oneor more suction ports and removable suction cups, in accordance with anembodiment of the invention; and

FIG. 11 is a perspective view of a vaginal surgical apparatus with oneor more movable prominence features, in accordance with an embodiment ofthe invention.

DETAILED DESCRIPTION

This invention relates generally to a medical device, and morespecifically, to a vaginal surgical apparatus. Certain embodiments ofthe invention are set forth in the following description and in FIGS.1-11 to provide a thorough understanding of such embodiments. Thepresent invention may have additional embodiments, may be practicedwithout one or more of the details described for any particulardescribed embodiment, or may have any detail described for oneparticular embodiment practiced with any other detail described foranother embodiment.

FIG. 1 is a top perspective view of a vaginal surgical apparatus, inaccordance with an embodiment of the invention. In one embodiment, anapparatus 102 includes, but is not limited to, an elongated handleportion 104; a vaginal manipulator probe 106 that is at least partlyinsertable into a vagina, the vaginal manipulator probe 106 extendingfrom the elongated handle portion 104 and including an arcuate endportion 108, the arcuate end portion 108 including an aperture 110 foraccommodating a cervix; and a disk 112 that is movable along at least aportion of a length of the vaginal manipulator probe 106, the disk 112including a locking mechanism 114 to releasably secure the disk 112 inposition to limit vaginal insertion depth of the vaginal manipulatorprobe 106. In one particular embodiment, the elongated handle portion104 is a cylindrical shaft 116. In another embodiment, the elongatedhandle portion 104 includes a recessed waist portion 118. In certainembodiments, the vaginal manipulator probe 106 is releasable from theelongated handle portion 104. Alternatively, in some embodiments, thevaginal manipulator probe 106 and the elongated handle portion 104 are aunitary structure. In one embodiment, the elongated handle portion 104includes a first bollard tab 120 and a second bollard tab (not visible)opposite the first bollard tab 120 for releasably securing a suture. Infurther embodiments, the vaginal manipulator probe 106 has an ovalcross-sectional shape along a length of a longitudinal axis of thevaginal manipulator probe 106. In one particular embodiment, the vaginalmanipulator probe 106 includes a first portion 122 having a firstcross-sectional width that flares to a second portion 124 having asecond cross-sectional width that is greater than thefirst-cross-sectional width, wherein the first portion 122 and thesecond portion 124 have substantially similar cross-sectional heights.In some embodiments, the vaginal manipulator probe 106 includes a notchtrack (not visible) for interfacing with the locking mechanism 114 ofthe disk 112. In additional embodiments, the vaginal manipulator probe106 includes a linear portion 126 that extends from the arcuate endportion 108. In one particular embodiment, the aperture 110 of thearcuate end portion 108 of the vaginal manipulator probe 106 extends asa channel 128 from a top surface 130 of the vaginal manipulator probe106 through to a bottom surface 132 of the vaginal manipulator probe106. In one embodiment, the aperture 110 is positioned approximatelymidway along a length of the arcuate end portion 108 of the vaginalmanipulator probe 106. In other embodiments, the vaginal manipulatorprobe 106 includes an end portion 134 that curls to define a bullous tip(not visible). In one specific embodiment, the aperture 110 measuresapproximately 2 cm to 4 cm across and/or in length. In some embodiments,the disk 112 is movable along a portion of a length of the vaginalmanipulator probe 106 having a notch track (not visible). In furtherembodiments, the disk 112 includes a sleeve portion 136 thatcircumscribes the vaginal manipulator probe 106. In other embodiments,the disk 112 includes a shoulder 138 that circumscribes the vaginalmanipulator probe 106, the shoulder 138 being operable to rest againstan outside surface of a vulva when the vaginal manipulator probe 106 isinserted within the vagina. In a further embodiment, the disk 112includes a spring-loaded latch 140 that is tensionally biased against anotch track (not visible) of the vaginal manipulator probe 106.

In one embodiment, an apparatus 102 includes, but is not limited to, anelongated handle portion 104 that includes a first bollard tab 120 and asecond bollard tab (not visible) for releasably securing a suture; avaginal manipulator probe 106 extending from the elongated handleportion 104 and including an arcuate end portion 108 having anoval-cross sectional shape and having an aperture channel 110 foraccommodating a cervix; and a disk 112 that is movable along at least aportion of a length of the vaginal manipulator probe 106, the disk 112including a locking mechanism 114 to releasably secure the disk 112 inposition to limit vaginal insertion depth of the vaginal manipulatorprobe 106.

In another embodiment, an apparatus 102 includes, but is not limited to,an elongated handle portion 104 that includes a first bollard tab 120and a second bollard tab (not visible) for releasably securing a suture;a vaginal manipulator probe 106 extending from the elongated handleportion 104 and including an arcuate end portion 108 having anoval-cross sectional shape and having an aperture channel 110 foraccommodating a cervix, the arcuate end portion 108 terminating to abullous tip (not visible); a disk 112 including a sleeve 136 andshoulder 138, the disk 112 being movable along at least a portion of alength of the vaginal manipulator probe 106; and a spring loaded latch140 associated with the disk 112 to releasably secure the disk 112 inposition along a length of the vaginal manipulator probe 106 to limitvaginal insertion depth.

In one embodiment, the elongated handle portion 104 includes a notch 101on opposing sides to define a surface for securing the apparatus 102,such as using a locking mechanism, clamp, clasp associated with a tableor resting surface.

In some embodiments, the cylindrical shaft 116 is non-cylindrical suchas oval, square, triangular, or irregular in shape. In otherembodiments, the cylindrical shaft 116 is non-linear, such as includinga bend or curve along its length. In further embodiments, the notch 101is omitted or substituted with a hole, channel, or protrusion.Alternatively, a clamp, clasp, or other securing mechanism can beincluded with the cylindrical shaft 116 to facilitate securing theapparatus 102 to a table, support, stand, or other structure. In someembodiments, the recessed waist 118 is omitted or can be duplicated atdifferent positions along a length of the cylindrical shaft to provideadditional grip points. In certain embodiments, the first bollard tab120 and the second bollard tab 202 can be omitted or positionable on arotatably lockable or slidable sleeve that permits differentalignment/positioning. In an additional embodiment, the cylindricalshaft 116 can be tapped with threads to permit screwing and unscrewingof the vaginal manipulator probe 106. Alternatively, the cylindricalshaft 116 can include a tapered, friction, bearing, post, groove, orother locking mechanism for removably securing the vaginal manipulatorprobe 106.

In an additional embodiment, the vaginal manipulator probe 106 isarcuate along a substantially entire length (e.g., curved along amajority of the length without having the linear portion 126). Thearcuate end portion 108 can have a curvature as depicted oralternatively can be curved to a greater or lesser extent as desired toaccommodate the vaginal anatomy. In certain embodiments, the arcuate endportion 108 can include an adjustable curvature to permit point-of-useadjustment by a health provider or doctor. Alternatively, the vaginalmanipulator probe 106 can be substantially linear along itssubstantially entire length (e.g., not including the arcuate end portion108). In certain embodiments, the linear portion 126 and the arcuate endportion 108 have a circular, oval, square, triangular, irregular, orother similar cross-sectional shape, which may be the same or differentbetween the two. In another embodiment, the linear portion 126 and thearcuate end portion 108 have substantially similar widths or heights orcan have differing widths or heights. In other embodiments, the arcuateend portion 108 can include a larger or smaller flare from the linearportion 126 to define a wider or narrower shape. In some embodiments,the arcuate end portion 108 can have a varying diameter, height, orcross sectional shape along its length. In other embodiments, the endportion 134 is flat, curved, pointed, conical, or has another similarshape. In a further embodiment, the aperture 110 can be a surfaceindentation or can extend fully or partly through the vaginalmanipulator probe 106. In one particular embodiment, walls of theaperture 110 are tapered in or out to define a surface for accommodatingvarious anatomical features. The aperture 110 can be square,rectangular, oval, circular, triangular, or another similar shape. Theaperture 110 can be positioned further towards the end portion 134 orfurther towards the linear portion 126. The aperture 110 can extendfurther along a length of the arcuate end portion 108 or can beshortened. Additionally, in some embodiments, the aperture 110 can beadjustable in width, height, depth, diameter, or shape. In otherembodiments, the disk 112 can include a larger or a smaller diametershoulder 138. The sleeve portion 136 can be omitted or extended furtherforward or aft to cover more of the linear portion 126. The linearportion 126 can include measurement markings to indicate a distance ofinsertion from the end portion 134. The locking mechanism 114 can beomitted or substituted, such as with a threaded disk that rotates, a pinand hole, a screw and track, or another similar structure.

In additional embodiments, the apparatus 102 includes one or morecameras 127 positioned at one or more points to provide visual feedback,such as proximate the end portion 134, along a length of the arcuate endportion 108, or proximate the aperture 110, as depicted. In certainembodiments, the one or more cameras 127 can be disposed on a topsurface 130 of the vaginal manipulator probe 106 or on a bottom surface132 of the vaginal manipulator probe or even on either side of thevaginal manipulator probe 106. In one particular embodiment, the one ormore cameras 127 are disposed on a top surface 130 and are angled topermit visualization of the aperture 110 relative to the cervix tofacilitate proper positioning of the cervix within the aperture 110.Alternatively, the one or more cameras 127 can be positioned along thevaginal manipulator probe 106—either on the linear portion 126 or thearcuate end portion 108—permitting visualization of the vaginalmanipulator probe 106 relative to various vaginal anatomical structuresand/or one or more needles or surgical tools. In certain embodiments,the one or more LED lights 125 are positioned to illuminate the aperture110 to facilitate imaging using the one or more cameras 127. The one ormore LED lights 125 are depicted as being proximate the one or morecameras 127 and positioned to illuminate the aperture 110. However, theone or more LED lights 125 are not limited to being positioned asdepicted. For example, in certain embodiments, the apparatus 102includes one or more LED lights 125 surrounding the aperture 110, whichone or more LED lights 125 emit light that is detectable through thetissue of a cervix and trans-illuminate tissue of the vagina. Thispositioning of the one or more LED lights 125 facilitates correctpositioning of the vaginal manipulator probe 106 relative to the cervix.The one or more LED lights 125 can be disposed around the aperture 110on the inside diameter walls or near a lip on the top surface 130 or thebottom surface 132. The one or more LED lights 125 can be positionedanywhere on the arcuate end portion 108 or the linear portion 126.Alternatively, the one or more LED lights 125 can be disposed anywherealong the vaginal manipulator probe 106 or even along the elongatedhandle portion 104. Thus, in certain embodiments, the one or morecameras 127 at a vantage point to visualize the aperture 110, with theone or more LED lights 125 adjacent. Another location for the one ormore LED lights 125 is on the top of a cervical “ring” in a series allaround the aperture 110, which would be in direct contact with thevagina where the vagina attaches to the cervix, therebytrans-illuminating the vagina at that junction for the surgeon/healthprovider to see from an abdominal perspective. Alternatively, the one ormore LED lights 125 could be in a small series of 3 or 4 lights at thejunction of the vaginal manipulator probe 106 where it transitions tothe aperture 110. Additionally, the vaginal manipulator probe 106 isconfigured to change or emit color/light, such as using one or moreinternal or externally mounted LED lights 125 to provide contrastrelative to tissue or blood. Batteries in any of these embodiments canbe disposed within the elongated handle portion 104.

In one particular embodiment, a display screen is included to permitdisplay of one or more images/video captured using the one or morecameras 127. The display screen can be integrated or coupled to theelongated handle portion 104 or can be detachable and removablycouplable to the elongated handle portion. The display screen can bepivoted, angled, shifted, moved to permit visualization by a healthcareprovider during application. The display screen can be disposable orreusable. The display screen can include or be associated with one ormore buttons or switches to permit control of the one or more LED lights125 or the one or more cameras 127. For instance, the one or more LEDlights 125 can be turned on or off or have varying intensity or color.Additionally, the one or more cameras 127 can be robotically moved,angled, shifted or can even enable zoom, image, video, contrast, etc.changes.

In further embodiments, the arcuate end portion 108 includes one or moreindentations or grooves on its surface to backstop a needle, similar infunction to a thimble. In some embodiments, one or more physiologicalsensors are disposed on a surface of the apparatus 102 or internally ofthe apparatus 102, such physiological sensors can provide data feedbackregarding temperature, chemical, coloration, or other similarinformation. In certain embodiments, the apparatus 102 includes aninternal conduit that exits via the end portion 134 or via one or morepores in the vaginal manipulator probe 106 for medication or fluiddelivery. The internal conduit can include an attachment point in theelongated handle portion for coupling with a catheter or other conduitfor receiving fluids or medication. Alternatively, the internal conductcan extend from a refillable reservoir disposed within the apparatus 102for containing fluid or medication. The apparatus 102 can furtherinclude a processor, computer readable storage, buttons, switches,and/or one or more wireless or wired communication units to enableautomatic, programmed, remote, or local control of the operations, suchas light, drug administration, sensors, data collection andtransmission, size or shape or curvature adjustments, or other similaroperations.

FIG. 2 is a bottom perspective view of a vaginal surgical apparatus, inaccordance with an embodiment of the invention. In one embodiment, anapparatus 102 includes, but is not limited to, an elongated handleportion 104; a vaginal manipulator probe 106 that is at least partlyinsertable into a vagina, the vaginal manipulator probe 106 extendingfrom the elongated handle portion 104 and including an arcuate endportion 108, the arcuate end portion 108 including an aperture 110 foraccommodating a cervix; and a disk 112 that is movable along at least aportion of a length of the vaginal manipulator probe 106, the disk 112including a locking mechanism 114 to releasably secure the disk 112 inposition to limit vaginal insertion depth of the vaginal manipulatorprobe 106. In one particular embodiment, the elongated handle portion104 is a cylindrical shaft 116. In another embodiment, the elongatedhandle portion 104 includes a recessed waist portion 118. In certainembodiments, the vaginal manipulator probe 106 is releasable from theelongated handle portion 104. Alternatively, in some embodiments, thevaginal manipulator probe 106 and the elongated handle portion 104 are aunitary structure. In one embodiment, the elongated handle portion 104includes a first bollard tab (not visible) and a second bollard tab 202opposite the first bollard tab for releasably securing a suture. Infurther embodiments, the vaginal manipulator probe 106 has an ovalcross-sectional shape along a length of a longitudinal axis of thevaginal manipulator probe 106. In one particular embodiment, the vaginalmanipulator probe 106 includes a first portion 122 having a firstcross-sectional width that flares to a second portion 124 having asecond cross-sectional width that is greater than thefirst-cross-sectional width, wherein the first portion 122 and thesecond portion 124 have substantially similar cross-sectional heights.In some embodiments, the vaginal manipulator probe 106 includes a notchtrack 204 for interfacing with the locking mechanism 114 of the disk112. In additional embodiments, the vaginal manipulator probe 106includes a linear portion 126 that extends from the arcuate end portion108. In one particular embodiment, the aperture 110 of the arcuate endportion 108 of the vaginal manipulator probe 106 extends as a channel128 from a top surface 130 of the vaginal manipulator probe 106 throughto a bottom surface 132 of the vaginal manipulator probe 106. In oneembodiment, the aperture 110 is positioned approximately midway along alength of the arcuate end portion 108 of the vaginal manipulator probe106. In other embodiments, the vaginal manipulator probe 106 includes anend portion 134 that curls to define a bullous tip 206. In one specificembodiment, the aperture 110 measures approximately 2 cm to 4 cm acrossand/or in length. In some embodiments, the disk 112 is movable along aportion of a length of the vaginal manipulator probe 106 having a notchtrack 204. In further embodiments, the disk 112 includes a sleeveportion 136 that circumscribes the vaginal manipulator probe 106. Inother embodiments, the disk 112 includes a shoulder 138 thatcircumscribes the vaginal manipulator probe 106, the shoulder 138 beingoperable to rest against an outside surface of a vulva when the vaginalmanipulator probe 106 is inserted within the vagina. In a furtherembodiment, the disk 112 includes a spring-loaded latch 140 that istensionally biased against a notch track 204 of the vaginal manipulatorprobe 106.

In one embodiment, an apparatus 102 includes, but is not limited to, anelongated handle portion 104 that includes a first bollard tab (notvisible) and a second bollard tab 202 for releasably securing a suture;a vaginal manipulator probe 106 extending from the elongated handleportion 104 and including an arcuate end portion 108 having anoval-cross sectional shape and having an aperture channel 110 foraccommodating a cervix; and a disk 112 that is movable along at least aportion of a length of the vaginal manipulator probe 106, the disk 112including a locking mechanism 114 to releasably secure the disk 112 inposition to limit vaginal insertion depth of the vaginal manipulatorprobe 106.

In another embodiment, an apparatus 102 includes, but is not limited to,an elongated handle portion 104 that includes a first bollard tab (notvisible) and a second bollard tab 202 for releasably securing a suture;a vaginal manipulator probe 106 extending from the elongated handleportion 104 and including an arcuate end portion 108 having anoval-cross sectional shape and having an aperture channel 110 foraccommodating a cervix, the arcuate end portion 108 terminating to abullous tip 206; a disk 112 including a sleeve 136 and shoulder 138, thedisk 112 being movable along at least a portion of a length of thevaginal manipulator probe 106; and a spring loaded latch 140 associatedwith the disk 112 to releasably secure the disk 112 in position along alength of the vaginal manipulator probe 106 to limit vaginal insertiondepth.

FIG. 3 is a perspective view of a handle portion of a vaginal surgicalapparatus, in accordance with an embodiment of the invention. In oneembodiment, the elongated handle portion 104 is a cylindrical shaft 116.In another embodiment, the elongated handle portion 104 includes arecessed waist portion 118. In certain embodiments, the elongated handleportion 104 is releasable from the vaginal manipulator probe (notshown). Alternatively, in some embodiments, the vaginal manipulatorprobe (not shown) and the elongated handle portion 104 are a unitarystructure. In one embodiment, the elongated handle portion 104 includesa first bollard tab (not visible) and a second bollard tab 202 oppositethe first bollard tab for releasably securing a suture. In anotherembodiment, the elongated handle portion 104 includes a notch 101 onopposing sides to define a planar surface for accommodating a clasp,clamp, or other securing mechanism to hold the apparatus in position.

FIG. 4 is a perspective view of a vaginal manipulator probe of a vaginalsurgical apparatus, in accordance with an embodiment of the invention.In one embodiment, the vaginal manipulator probe 106 has an ovalcross-sectional shape along a length of a longitudinal axis of thevaginal manipulator probe 106. In one particular embodiment, the vaginalmanipulator probe 106 includes a first portion 122 having a firstcross-sectional width that flares to a second portion 124 having asecond cross-sectional width that is greater than thefirst-cross-sectional width, wherein the first portion 122 and thesecond portion 124 have substantially similar cross-sectional heights.In some embodiments, the vaginal manipulator probe 106 includes a notchtrack 204 for interfacing with the locking mechanism 114 of the disk112. In additional embodiments, the vaginal manipulator probe 106includes a linear portion 126 that extends from the arcuate end portion108. In one particular embodiment, the aperture 110 of the arcuate endportion 108 of the vaginal manipulator probe 106 extends as a channel128 from a top surface 130 of the vaginal manipulator probe 106 throughto a bottom surface 132 of the vaginal manipulator probe 106. In oneembodiment, the aperture 110 is positioned approximately midway along alength of the arcuate end portion 108 of the vaginal manipulator probe106. In other embodiments, the vaginal manipulator probe 106 includes anend portion 134 that curls to define a bullous tip 206. In one specificembodiment, the aperture 110 measures approximately 2 cm to 4 cm acrossand/or in length. In some embodiments, the disk 112 is movable along aportion of a length of the vaginal manipulator probe 106 having a notchtrack 204. In further embodiments, the disk 112 includes a sleeveportion 136 that circumscribes the vaginal manipulator probe 106. Inother embodiments, the disk 112 includes a shoulder 138 thatcircumscribes the vaginal manipulator probe 106, the shoulder 138 beingoperable to rest against an outside surface of a vulva when the vaginalmanipulator probe 106 is inserted within the vagina. In a furtherembodiment, the disk 112 includes a spring-loaded latch 140 that istensionally biased against a notch track 204 of the vaginal manipulatorprobe 106.

FIG. 5 is a perspective view of a vaginal manipulator probe of a vaginalsurgical apparatus inserted into a vaginal space, in accordance with anembodiment of the invention. In one embodiment, an apparatus 102includes, but is not limited to, an elongated handle portion 104; avaginal manipulator probe 106 that is at least partly insertable into avagina 502, the vaginal manipulator probe 106 extending from theelongated handle portion 104 and including an arcuate end portion 108,the arcuate end portion 108 including an aperture 110 for accommodatinga cervix 504; and a disk 112 that is movable along at least a portion ofa length of the vaginal manipulator probe 106, the disk 112 including alocking mechanism 114 to releasably secure the disk 112 in position tolimit vaginal insertion depth of the vaginal manipulator probe 106. Inone particular embodiment, the elongated handle portion 104 is acylindrical shaft 116. In another embodiment, the elongated handleportion 104 includes a recessed waist portion 118. In certainembodiments, the vaginal manipulator probe 106 is releasable from theelongated handle portion 104. Alternatively, in some embodiments, thevaginal manipulator probe 106 and the elongated handle portion 104 are aunitary structure. In one embodiment, the elongated handle portion 104includes a first bollard tab (not visible) and a second bollard tab 202opposite the first bollard tab for releasably securing a suture 506. Infurther embodiments, the vaginal manipulator probe 106 has an ovalcross-sectional shape along a length of a longitudinal axis of thevaginal manipulator probe 106. In one particular embodiment, the vaginalmanipulator probe 106 includes a first portion 122 having a firstcross-sectional width that flares to a second portion 124 having asecond cross-sectional width that is greater than thefirst-cross-sectional width, wherein the first portion 122 and thesecond portion 124 have substantially similar cross-sectional heights.In some embodiments, the vaginal manipulator probe 106 includes a notchtrack 204 for interfacing with the locking mechanism 114 of the disk112. In additional embodiments, the vaginal manipulator probe 106includes a linear portion 126 that extends from the arcuate end portion108. In one particular embodiment, the aperture 110 of the arcuate endportion 108 of the vaginal manipulator probe 106 extends as a channel128 from a top surface (not visible) of the vaginal manipulator probe106 through to a bottom surface 132 of the vaginal manipulator probe106. In one embodiment, the aperture 110 is positioned approximatelymidway along a length of the arcuate end portion 108 of the vaginalmanipulator probe 106. In other embodiments, the vaginal manipulatorprobe 106 includes an end portion 134 that curls to define a bulloustip. In one specific embodiment, the aperture 110 measures approximately2 cm to 4 cm across and/or in length. In some embodiments, the disk 112is movable along a portion of a length of the vaginal manipulator probe106 having the notch track 204. In further embodiments, the disk 112includes a sleeve portion 136 that circumscribes the vaginal manipulatorprobe 106. In other embodiments, the disk 112 includes a shoulder 138that circumscribes the vaginal manipulator probe 106, the shoulder 138being operable to rest against an outside surface of a vulva 508 whenthe vaginal manipulator probe 106 is inserted within the vagina 502. Ina further embodiment, the disk 112 includes a spring loaded latch 140that is tensionally biased against the notch track 204 of the vaginalmanipulator probe 106.

In one embodiment, an apparatus 102 includes, but is not limited to, anelongated handle portion 104 that includes a first bollard tab (notvisible) and a second bollard tab 202 for releasably securing a suture506; a vaginal manipulator probe 106 extending from the elongated handleportion 104 and including an arcuate end portion 108 having anoval-cross sectional shape and having an aperture channel 110 foraccommodating a cervix 504; and a disk 112 that is movable along atleast a portion of a length of the vaginal manipulator probe 106, thedisk 112 including a locking mechanism 114 to releasably secure the disk112 in position to limit vaginal insertion depth of the vaginalmanipulator probe 106.

In another embodiment, an apparatus 102 includes, but is not limited to,an elongated handle portion 104 that includes a first bollard tab (notvisible) and a second bollard tab 202 for releasably securing a suture506; a vaginal manipulator probe 106 extending from the elongated handleportion 104 and including an arcuate end portion 108 having anoval-cross sectional shape and having an aperture channel 110 foraccommodating a cervix 504, the arcuate end portion 108 terminating to abullous tip; a disk 112 including a sleeve 136 and shoulder 138, thedisk 112 being movable along at least a portion of a length of thevaginal manipulator probe 106; and a spring loaded latch 140 associatedwith the disk 112 to releasably secure the disk 112 in position along alength of the vaginal manipulator probe 106 to limit vaginal insertiondepth.

FIG. 6 is a perspective view of a movable handle of a vaginal surgicalapparatus, in accordance with an embodiment of the invention. In oneembodiment, a movable handle 602 includes an elongated portion 604movably coupled to a handle portion 606 via an articulating joint 610.The handle portion 606 includes a grip. The elongated portion 604includes a shaft with a recessed waist 614 terminating at a vaginalmanipulator probe attachment end 620. The shaft 612 can include a firstbollard tab 616 and a second bollard tab 618 for securing one or moresutures (not visible). Accordingly, the movable handle 602 can be usedin conjunction with various embodiments disclosed herein to provide analternative handle structure for manipulating a vaginal manipulatorprobe 106.

In certain embodiments, wherein the elongated portion 604 is acylindrical shaft. In other embodiments, the elongated portion 604includes a recessed waist 614 for accommodating a thumb. In otherembodiments, the elongated portion 604 is releasable from a vaginalmanipulator probe 106. In further embodiments, the elongated portion 604and a vaginal manipulator probe are provided as a unitary structure.

In some embodiments, the handle portion 606 rotates and/or pivotsrelative to the elongated portion 604. The articulating joint 610 canpermit movement in one, two, or three directions, such as being capableof adjustably extending from the elongated portion 604. In certainembodiments, the articulating joint is lockable in one or more positionsvia friction, a locking mechanism (e.g., pin, screw, jam nut, or similarstructure), or is freely movable. In other embodiments, the handleportion 606 includes a shaft grip, a knob, one or more finger holes, ora differently configured grip 608 (e.g., narrower, wider, thicker,thinner, etc.).

In further embodiments, the shaft 612 is differently configured, such asshorter, longer, wider, non-linear, squared, or the like. The shaft 612can be removably coupled to the vaginal manipulator probe as discussedherein, or can be part of a unitary structure with the vaginalmanipulator probe. The recessed waist 614 can be differently positioned,duplicated, longer, deeper, shorter, or even omitted. The first andsecond bollard tabs 616 and 618 can be omitted or differentlypositioned, such as on a rotatable or movable sleeve.

In one particular embodiment, a movable handle 602 is similar to thepart that you hold on a child's red wagon. The movable handle 602 can bean option to slip onto or couple with the vaginal manipulator probe 106.The movable handle 602 can be secured in place with a spring-loadedbutton or other simple device, and have a short extension which swivelsin the anterior-posterior plane only allowing several handle positions,perhaps three. The movable handle 602 includes an opening (where thesurgeon's fingers would be located) which enables access to the analcanal with a separate probe.

In one other particular embodiment, the elongated portion 104 or 604 hasa bend or is offset from a midline to define a space that accommodates arectal probe (which extending straight out of the anus) withoutconflicting with each other. This allows for easier positioning of theapparatus. It would also allow easier positioning of the apparatus 102while concurrently suing a rectal probe—maintaining the apparatus 102 inthe midline, rather than having it at an eccentric angle.

FIG. 7 is a perspective view of a vaginal surgical apparatus with one ormore prominence features, in accordance with an embodiment of theinvention. In one instance, an apparatus includes, but is not limitedto, a vaginal manipulator probe 700 that is at least partly insertableinto a vagina, the vaginal manipulator probe including an end portion702 that includes a bullous tip and that includes a space 704 thataccommodates a cervix therewithin; and at least one prominence 706incorporated with the vaginal manipulator probe 700 operable to assistwith identifying one or more positions of at least one anatomicalstructure or orienting the vaginal manipulator probe 700. In oneparticular embodiment, the prominence 706 comprises at least one lightprominence incorporated with the vaginal manipulator probe 700 operableto assist with identifying one or more positions of at least oneanatomical structure or orienting the vaginal manipulator probe. Forexample, the prominence 706 can includes at least one light lineincorporated with the vaginal manipulator probe 700 operable to assistwith identifying one or more positions of at least one anatomicalstructure or orienting the vaginal manipulator probe 700. Alternativelyor additionally, the probe 700 can include at least one light surface708 incorporated with the vaginal manipulator probe operable to assistwith identifying one or more positions of at least one anatomicalstructure or orienting the vaginal manipulator probe 700. In certainembodiments, the at least one light prominence 706 or light surface 708is incorporated around a circumference of the vaginal manipulator probe700 operable to assist with identifying one or more positions of atleast one anatomical structure or orienting the vaginal manipulatorprobe 700. Further, the at least one light prominence 706 or lightsurface 708 can be incorporated on a surface of the vaginal manipulatorprobe 700 operable to assist with identifying one or more positions ofat least one anatomical structure or orienting the vaginal manipulatorprobe 700. In one specific embodiment, the at least one light prominence706 or light surface 708 can be incorporated at a tip of the vaginalmanipulator probe 700 operable to assist with identifying one or morepositions of at least one anatomical structure or orienting the vaginalmanipulator probe 700. In another particular embodiment, the probe 700can include at least one two light prominences 706 or light surfaces 708of different colors incorporated with the vaginal manipulator probe 700operable to assist with identifying one or more positions of at leastone anatomical structure or orienting the vaginal manipulator probe 700.The at least one prominence 706 or 708 can be incorporated with thevaginal manipulator probe 700 operable to assist with identifying aninsertion distance of the vaginal manipulator probe 700 relative to ananatomical structure. Additionally or alternatively, the at least oneprominence 706 or 708 can be incorporated with the vaginal manipulatorprobe 700 operable to assist with positioning the vaginal manipulatorprobe 700 relative to an anatomical structure.

This technology disclosure can assist a surgeon in identifying anatomiclandmarks which would facilitate accuracy of graft placement and thetimely completion of sacrocolpopexy-type procedures. There are issuessolved related to identifying the extent of dissection between thevagina and the rectum posteriorly and the bladder anteriorly. On theposterior recto-vaginal interface, the dissection is ideally extendeddown from above to the pelvic floor, where the graft may then be suturedinto position. It can be difficult to identify when this depth isreached. Having a prominence such as a bright LED in the probe enablesvisual perception through the tissues about, for example, 1 cm above theperineal disc, and perhaps others at, for example, 2 and 3 cm above, toallow for atomic variation and help a surgeon know the dissection wascomplete. This can be done without necessitating an external exam toverify, saving time and expense.

Similarly on the anterior interface between vagina and bladder, a seriesof prominence features, such as lights could identify where the bladdertrigone is beginning and therefore the dissection complete. For example,LEDs could be around 5-8 cm above the perineal disc on the top surfaceof the probe.

Other options which improve the ability of a surgeon to identifyanatomic areas and/or maintain the vagina and cervix in the properposition during vaginal and/or rectal prolapse procedures include, butare not limited to: a series of circumferential lights, for example as athin band encircling the probe shaft to mark a certain distance and thatare bright enough to be seen through the tissue by the surgeon operatinglaparoscopically (e.g., 1 or 2 cm from the hymen or probe perineal discand then another band at 5 cm and then finally a lighted broader area atthe probe tip to indicate the position of the vaginal apex).

The lights can be manufactured with simple, inexpensive materials,and/or could be disposable. The lights can be either connected to alight source in the operating room via optical fibers, or can beindependent LED lights with small batteries. Lighted features or bandscan vary in width and location long the probe shaft and/or can usedifferent colors to indicate different depths, such as white, red, andblue. The tip light could be a different configuration such as solid ora continuous series along the tip.

Additionally or alternatively, the probe shaft could be hollow with asingle or multiple internal bright lights within it and the “lightedband” or prominence could simply be a clear plastic ring allowing thetransmission of light from that internal source. The internal probelight could provide light for both bands and the tip, eliminating theneed for multiple lights and complexity. Another simpler design could bea single circular light (or clear plastic light-transmissible material),created by an LED or other internal probe source, with the resultlooking like the end of a flashlight. This could be perhaps 2-10 mmdiameter with a single posterior position about 2 cm above the averageposition of the perineal disc, and in an anterior position about 7 cmabove the perineal disc, corresponding to the level of the internalpelvic floor muscles (posteriorly) and the top of the bladder trigone(anteriorly), respectively.

FIG. 8 is a perspective view of a vaginal surgical apparatus with one ormore prominence features, in accordance with an embodiment of theinvention. In one embodiment, the probe 700 can include one or moreprominences 802 positioned at various points about a surface of theprobe to assist with orienting the probe 700 relative to tissue. Forinstance, there can include spaced single lights with one on each sideand one in middle, just one in middle, just on a side, etc. to assistwith orientation of the probe 700 or tip in the midline of the vaginalcuff. Also, as an additional light-option, a single posterior lightedarea closer to the disc and a higher single lighted area anteriorly canbe employed. There may also include a topographically-adjustable“prominence” which may or not include a lighted feature.

Note that any of the features and embodiments disclosed and illustratedwith respect to FIGS. 7 and 8 may further include any of the features orembodiments disclosed and illustrated elsewhere in the specification anddrawings. Likewise, other portions of the specification and drawings canincorporate any of the features and embodiments disclosed andillustrated with respect to FIGS. 7 and 8.

FIG. 9 is a perspective view of a vaginal surgical apparatus with one ormore suction ports, in accordance with an embodiment of the invention.In one embodiment, an apparatus includes, but is not limited to, avaginal manipulator probe 900 that is at least partly insertable into avagina, the vaginal manipulator probe 900 including an end portion 902that includes a bullous tip 904 and that includes a space 906 thataccommodates a cervix therewithin; and at least one suction mechanism908 incorporated with the vaginal manipulator probe 900 operable toassist with stabilizing the vaginal manipulator probe 900 relative totissue. In one embodiment, the at least one suction mechanism 908comprises at least one suction cup incorporated within a cervical wellor on a surface of the vaginal manipulator probe operable to assist withstabilizing the vaginal manipulator probe relative to tissue.

The tissue stabilization device disclosed herein can be applied to agynecologic surgery. The probe can be inserted into the vagina,positioned with the cervix in the well, and suction can be applied(e.g., using a valve control) to maintain probe for the surgery. Toreposition, the suction is released and the device is repositionedbefore suction is applied again.

Many alternative embodiments are possible. For example, the cuppedportion which accepts a cervix can have suction holes embedded in itwhich are connected to wall suction at the opposite probe end which isoutside the body. A valve can be included to apply the suction when thedevice is placed (e.g., close the valve to maintain the suction orre-open the valve if repositioning is needed). These suction holes orcups, similar to a starfish or octopus, could also be available overdifferent sections of the probe tip and shaft if needed to maintain theorientation of the vaginal mucosa adjacent to the probe and prevent theprobe “wandering” to an incorrect position which often occurs during aprocedure. A series valves can be associated with a manifold thatprovides reduced pressure (suction) to different portions of the probeor to any combination of the valves. The suction can be powerful enoughto hold the probe in place without connection to an outside-the-bodydevice.

In additional embodiments, the suction can be provided via one orseveral suctions cups of differing sizes, such as several 3-4 mm cups orone 2 cm central cup. The suction cups can be rounded, linear, or anyother shape. Small, funnel-shaped silicone suction cups could be pressedinto holes positioned around the inside of walls of the cervical well.These soft silicone suction cups can be removed easily if not desired.The suction cups can connect to plastic tubing within the probe, whichthen connects to a manifold to accommodate up to 4 separate tubes, thento a three-way stop-cock valve, to which the operating room suctiontubing could be connected to apply suction. Alternatively, there can bea single connection tube from the cervical well suction to a valve. Thedevice can optionally include silicone plugs or tape to occlude theholes or a portion of the holes to allow for use of one size cervicalwell to work with different cervical sizes. For example, the surgeonmight elect to have the tissue stabilization suction limited to part ofthe well to hold a smaller cervix, which would allow the suction tocontact a portion of the cervix. Alternatively, there can be multiple(e.g., 3-4) suction cups in the deepest part of the cervical well whichcould hold the tissue for a wide variety of cervical sizes withoutattempting to fit the cervix width exactly.

In certain embodiments, the suction can be provided by multiple smallcups around the periphery, multiple (e.g., 3-4) larger central cups inthe area of the depression for the cervix, a single large cup in thearea, a shallow depression for the cervix with a single central cupextending beyond the edge of the probe surface which can contact thevaginal mucosa (e.g, for patients who no longer have a cervix (alreadyhad a hysterectomy)), and/or a single cup centrally located on the tipin the middle at the end of the probe, such as between or intermixedwith lights (e.g, there can be a light on each side and the suction cupin the middle).

One particular design can include a removable suction cup with athreaded “neck” which can be moved from the cervical depression area tothe tip area in cases where the cervix was missing or in a differentposition. Thus, the cup can be easily moved to the tip and threaded intoposition, while the other hole can be sealed with a threaded plug orpush-in silicone plug to maintain the vacuum.

FIG. 10 is a perspective view of a vaginal surgical apparatus with oneor more suction ports and removable suction cups, in accordance with anembodiment of the invention. In one embodiment, an apparatus includes,but is not limited to, a plurality of differential suction mechanisms1002 incorporated with the vaginal manipulator probe 900 operable toassist with stabilizing the vaginal manipulator probe 900 relative totissue.

In certain embodiments, the suction mechanism 1002 can include one ormore various types of suction cups, including threaded suction cups 1004and snap-in suction cups 1006. The threaded suction cups 1004 caninclude screw type threads that spin into one or more orifices in theprobe 900. The snap-in suction cups 1006 can be friction fit ormechanically fit (e.g. protrusion or ring prominence engaged into matingportion) into one or more orifices in the probe 900. A plurality oforifices can be positioned over sides, top, bottom, tip, cervical wellto receive the suction cups 1004 and/or 1006. Unused orifices can beplugged using thread or snap in type plugs to maintain the suctionpressure. The cups 1004 and/or 1006 can include different cup shapesand/or sizes (e.g., square, rectangular, irregular, circular, oval,triangular and/or small, medium, large, extra-large sizes). The cupsthemselves can include light or permit light to pass (e.g., translucent)similar to the other prominences disclosed herein for positioning anddepth insertion determinations.

Note that any of the features and embodiments disclosed and illustratedwith respect to FIGS. 9 and 10 may further include any of the featuresor embodiments disclosed and illustrated elsewhere in the specificationand drawings. Likewise, other portions of the specification and drawingscan incorporate any of the features and embodiments disclosed andillustrated with respect to FIGS. 9 and 10.

FIG. 11 is a perspective view of a vaginal surgical apparatus with oneor more movable prominence features, in accordance with an embodiment ofthe invention. In one embodiment, at least one light prominence 1102 isincorporated with the vaginal manipulator probe 1100 operable to assistwith identifying one or more positions of at least one anatomicalstructure or orienting the vaginal manipulator probe 1100. For example,the light prominence 1102 can include at least one light ring that isincorporated with the vaginal manipulator probe 1100 operable to assistwith identifying one or more positions of at least one anatomicalstructure or orienting the vaginal manipulator probe 1100. The lightprominence 1102 can include at least one movable or repositionable lightprominence 1102 that is incorporated with the vaginal manipulator probe1100 operable to assist with identifying one or more positions of atleast one anatomical structure or orienting the vaginal manipulatorprobe 1100. Alternatively, the light prominence 1104 can be incorporatedalong a portion of a length of the vaginal manipulator probe 1100operable to assist with identifying one or more positions of at leastone anatomical structure or orienting the vaginal manipulator probe1100.

With regard to the lighted bands on the probe shaft, their locationwould vary depending on the depth of the vagina, and therefore wouldindicate the distance the probe has been inserted up to the adjustableperineal disc. This distance could be set by a surgeon at the time ofapplication and can be adjustable (e.g., would be within a predictablerange, such as 1-8 cm from the perineal disc). The lighted band or bandscan surround the probe shaft and move similar to sliding a washer up ordown a bolt or can move by rolling. Additionally, the added prominenceof the lighted band above the surface of the probe would create anotheruseful feature, namely that the surgeon can palpate the “bump” on theother side (the abdominal side) of the tissue. Thus, even without alight, because in some cases the band is unlit, the prominence itselfcreates a landmark to indicate the corresponding anatomic feature (e.g.,the inner surface of the pelvic floor muscles) which is the appropriatedepth to stop the dissection from above. A similar feature is providedwith an additional lighted band higher up on the shaft, which canindicate the cephalic border of the bladder trigone. Again, due to itspalpability, this prominence would be effective even if there was novisible light. Any of the aforementioned bands can be secured using aseries of dimples 1106 along a length that resist movement of the bandor can be secured by a cam lever, thumb screw, clip, or other mechanism.In the case of the lit bands, wire leads can be provided or the band canhave a metal contact portion that interfaces with metal contact on theprobe shaft (e.g., metal contact portions in the dimples 1106 cantransfer electrons to the band for light power). Alternatively, thebands can be glowing or translucent and illuminated, such as via a lightsource positioned at the dimple portions 1106.

In certain embodiments, lights can be along the probe body in theanterior and posterior midline. The difference being the anteriorlighted region would be further “inside” the patient than the posteriorlighted area. For example, the anterior band would span the distancefrom the perineum of approximately 5-9 cm, while on the posterior sideit would be 1-4 cm.

Note that any of the features and embodiments disclosed and illustratedwith respect to FIG. 11 may further include any of the features orembodiments disclosed and illustrated elsewhere in the specification anddrawings. Likewise, other portions of the specification and drawings canincorporate any of the features and embodiments disclosed andillustrated with respect to FIG. 11.

While preferred and alternate embodiments of the invention have beenillustrated and described, as noted above, many changes can be madewithout departing from the spirit and scope of the invention.Accordingly, the scope of the invention is not limited by the disclosureof these preferred and alternate embodiments. Instead, the inventionshould be determined entirely by reference to the claims that follow.

What is claimed is:
 1. An apparatus comprising: a vaginal manipulatorprobe that is at least partly insertable into a vagina, the vaginalmanipulator probe including an end portion that includes a tip and thatincludes a space that is configured to accommodate a cervix at leastpartly therewithin; and at least two light prominences of differentcolors incorporated with the vaginal manipulator probe and operable toassist with positioning or orienting the vaginal manipulator probe. 2.The apparatus of claim 1, wherein at least one of the at least two lightprominences comprises at least one light ring.
 3. The apparatus of claim1, wherein at least one of the at least two light prominences comprisesat least one light surface.
 4. The apparatus of claim 1, wherein atleast one of the at least two light prominences comprises at least onelight line.
 5. The apparatus of claim 1, wherein at least one of the atleast two light prominences is incorporated around a circumference ofthe vaginal manipulator probe.
 6. The apparatus of claim 1, wherein atleast one of the at least two light prominences is incorporated along aportion of a length of the vaginal manipulator probe.
 7. The apparatusof claim 1, wherein at least one of the at least two light prominencesis incorporated on a surface of the vaginal manipulator probe.
 8. Theapparatus of claim 1, wherein at least one of the at least two lightprominences is incorporated at the tip of the vaginal manipulator probe.9. The apparatus of claim 1, wherein at least one of the at least twolight prominences is operable to assist with identifying an insertiondistance of the vaginal manipulator probe.
 10. The apparatus of claim 1,wherein at least one of the at least two light prominences is operableto assist with maintaining an orientation of the vaginal manipulatorprobe.
 11. An apparatus comprising: a vaginal manipulator probe that isat least partly insertable into a vagina, the vaginal manipulator probeincluding an end portion that includes a tip and that includes a spaceconfigured to accommodate a cervix at least partly therewithin; and atleast one suction orifice incorporated with the vaginal manipulatorprobe and operable to assist with stabilizing the vaginal manipulatorprobe relative to tissue.
 12. The apparatus of claim 11, wherein the atleast one suction orifice comprises at least one suction cup.
 13. Theapparatus of claim 11, wherein the at least one suction orificecomprises a plurality of differently sized suction cups.
 14. Theapparatus of claim 11, further comprising: at least one adjustablesuction valve.
 15. The apparatus of claim 11, further comprising: one ormore suction plugs.
 16. The apparatus of claim 11, wherein the at leastone suction orifice is incorporated within a cervical well or on asurface of the vaginal manipulator probe.
 17. The apparatus of claim 11,wherein the at least one suction orifice further comprises: at least oneremovable suction cup.
 18. An apparatus comprising: a vaginalmanipulator probe that is at least partly insertable into a vagina, thevaginal manipulator probe including an end portion that defines a spacethat is configured to accommodate a cervix at least partly therewithin;and at least one movable or repositionable light prominence associatedwith the vaginal manipulator probe and operable to assist withpositioning or orienting the vaginal manipulator probe.
 19. Theapparatus of claim 18, wherein the at least one movable orrepositionable light prominence comprises at least one light ring. 20.The apparatus of claim 18, wherein the at least one movable orrepositionable light prominence comprises at least one light band. 21.The apparatus of claim 18, wherein the at least one movable orrepositionable light prominence further defines a bump-type landmark.22. The apparatus of claim 18, wherein the at least one movable orrepositionable light prominence derives its light by glowing.